Pregnancy Diabetes
General overview
One may have heard of type 1 diabetes or type 2 diabetes, yet gestational diabetes is just as common and is rarely talked about, so let's talk about it! Along with all the types of diabetes, gestational diabetes (GD) is just another type that affects a specific group of people. GD is generally a form of diabetes that appears during pregnancy, hence “gestational” referring to the development of a fetus, and typically resolves after childbirth; however, it is much more complex. Like other forms of diabetes, GD affects how the body's cells use sugar which is caused by insulin resistance. GD can heavily affect the development of the baby, potentially causing elevated blood glucose levels, excess birth weight, underdeveloped lungs, stillbirth, postpartum hypoglycemia, and or maternal pre-eclampsia (high blood pressure). What makes this form of diabetes so incredibly different is it is not chronic and often comes during pregnancy and leaves after birth. Yet, GD may influence both the mother’s and baby's health even after birth if not properly managed.
What Are the Symptoms to Gestational Diabetes?
The symptoms of GD most often coincide with regular pregnancy symptoms, making it difficult to detect. This is why routine screening between 24 and 28 weeks of pregnancy is necessary to detect GD and to handle it properly in the future. Some symptoms of GD include…
- Frequent urination
- Excessive thirst
- Fatigue
- Blurred vision
- Increased hunger
- Nausea
- Frequent infections
It is clear that these symptoms go for a healthy pregnancy as well, making the entire diagnosis for GD much harder and much more dangerous. It is highly suggested for pregnant mothers to get medically tested, especially if GD runs in the family, to ensure the health of the baby and the mother herself.
What Are the Causes of Gestational Diabetes?
It is understood that GD occurs during pregnancy, yet the explanation truly lies within the shifts and changes created during pregnancy. During the first stages of pregnancy, the mother’s body produces many hormones (cortisol, estrogen, etc.) which makes the cells less sensitive to insulin. This allows a constant supply of glucose for the fetus. However, the underlying problem of gestational diabetes is the body's inability to overcome the insulin resistance that follows. In non-diabetic pregnancy, the mother’s body compensates for the resistance through the pancreas growing in size and creating more beta-cells, which are in charge of insulin production. Mothers with GD face a pancreatic defect that prevents the pancreas to oversupply insulin for herself and the baby. There are also factors that put one at higher risk from developing GD, as this condition is not guaranteed for all pregnant women. Genetic predisposition is the most common risk factor for all forms of diabetes. Having a family history of GD or some form of genetic mutation regarding insulin production puts one at an even higher risk. There are also many cases where a pancreatic defect is present prior to pregnancy and only gets revealed because of metabolic stress. Even if these underlying risk factors apply to you, there’s no need to be afraid of getting pregnant as the development of GD is not guaranteed and GD itself is very manageable.
Possible Complications
Having gestational diabetes can lead to complications for both the mother and the baby. Possible complications for the mother during and after birth could be…
- High blood pressure/Preeclampsia - a serious blood pressure disorder that often requires early delivery. May threaten the lives of both the mother and the baby
- Needing to have a C-section - a surgical delivery with an incision into the uterus.
- Developing Type 2 Diabetes (T2D)
- High blood glucose levels/Hyperglycemia
The mother is at risk for many future complications; however, GD most often affects the baby more than the actual mother. The baby is at risk for many complications due to GD affecting the development of the fragile fetus. Possible risks for the baby may be…
- High birth weight/Macrosomia -- referring to a baby that is considerably larger and heavier than normal. Because of the mother having GD, the maternal blood circulating through the fetus has high glucose levels. This excess glucose getting delivered to the fetus gets converted to fats. Macrosomia includes babies that are around 9 pounds or higher which often forces the mother to get a C-section–a surgical procedure to deliver a baby through incisions in the mother's abdomen and uterus.
- Hypoglycemia -- having low blood sugar levels immediately after birth. Because the maternal blood is consistently being high, the fetus has grown some form of tolerance by creating a lot of insulin. Once the baby is born, he/she is faced with normal glucose levels and high insulin levels, leading to hypoglycemia.
- Early birth -- Early birth could happen naturally as well as being medically induced. GD may create hormonal imbalance and inflammation eventually triggering premature labor. Yet, there are times where complications in the mother and the baby get too severe, to the point where early birth is necessary to maintain the health for both the mother and the baby. Complications occurring in the baby, such as macrosomia, may prompt an emergency C-section due to its immensely growing size. And complications in the mother, such as preeclampsia, may prompt for an early birth to ensure the safety of the baby.
- Still birth – process in which the baby has passed inside the uterus. When the mother has hyperglycemia (high glucose), the fetus often develops fetal hyperglycemia. This leads to excessive insulin production within the fetus, stimulating fetal metabolism. Fetal metabolism takes up much of the oxygen supply from the placenta, leaving the fetus to be oxygen deprived for development/other metabolic processes. Another possible cause is the high glucose levels damaging blood vessels in the placenta, causing inflammation. This may disturb the placenta’s ability to transport oxygen efficiently.
Holistic Approach
Gestational diabetes can be a scary disease due to it jeopardizing the health of both the mother and baby; however, the possible complications are very unlikely to occur when one follows the correct steps. The primary goal when dealing with GD is to keep blood glucose at a normal level, in which the holistic approach involves maintaining or shifting one's everyday habits. An individual’s diet has a crucial effect on his or her management of diabetes. Creating a specialized meal plan with a healthcare provider would be most beneficial, but generally choosing a variety of foods high in fiber and low in fat and calories is a great start. Exercise as well will also significantly affect the management of GD, but it may be daunting to figure out what is best during pregnancy. Some low-impact activities such as walking, doing yoga, and swimming are all helpful for dealing with GD as well as leading to a great pregnancy.
As easy as it may sound, these tiny shifts in one’s lifestyle can dramatically help the journey to having a healthy delivery. It is key to remember that holistic medicine is comprehensive in form and it may be beneficial to consult with a professional health caretaker for more specific recommendations and practices!